European Spine Journal最新文献

{"title":"Short-term efficacy of unilateral biportal endoscopy technology in the treatment of cervical spondylotic radiculopathy.","authors":"Mohan Wen, Xu Li, Xiangjun Lu, Tianzuo Chen, Rujie Qin","doi":"10.1007/s00586-024-08545-7","DOIUrl":"https://doi.org/10.1007/s00586-024-08545-7","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical efficacy of unilateral biportal endoscopy technology (UBE) with anterior cervical discectomy and fusion(ACDF)for the treatment of single-segment cervical spondylotic radiculopathy (CSR).</p><p><strong>Methods: </strong>Retrospective analysis of 60 patients with CSR, of which 30 were treated with ACDF (group A) and 30 were treated with UBE (group B). Cision length, operation time, intraoperative blood loss, hospitalization duration, postoperative complications preoperative and postoperative VAS, NDI scores, height and stability of the liability gap were compared between the two groups.</p><p><strong>Results: </strong>Compared with the A group, the incision length, duration and intraoperative blood loss were significantly less in the B group (P < 0.05), and the difference was statistically significant. As the postoperative time increased, the VAS score and NDI score decreased significantly in both groups (P < 0.05or < 0.01). However, the differences in VAS and NDI scores between the two groups at the corresponding time points were not statistically significant, and only the VAS score at 1 day postoperatively showed a more pronounced decrease in the B group, which was statistically significant compared with that in the A group. The difference in intervertebral space height and stability of the postoperative liability gap between the two groups at the final follow-up was not statistically significant when compared with the preoperative period. The incidence of postoperative complications in the two groups was smaller in the B group than in the A group, and the difference was not statistically significant.</p><p><strong>Conclusions: </strong>UBE can effectively treat patients with single-segment CRS and promote rapid recovery.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal effects of plasma proteome on intervertebral disc degeneration: a comprehensive mendelian randomization study.","authors":"Bo-Wen Ren, Yi-Hao Liu, Jian-Hui Wu, Bo-Chen An, Qing-Zu Liu, Chong-Yang Liu, Ke-Ya Mao, Jian-Heng Liu","doi":"10.1007/s00586-024-08551-9","DOIUrl":"https://doi.org/10.1007/s00586-024-08551-9","url":null,"abstract":"<p><strong>Purpose: </strong>Intervertebral disc degeneration (IVDD) considerably impacts global disability and quality of life. Although potential links between plasma proteins and IVDD exist, their causal correlation remains undefined. This study explored the causal links between plasma proteins and IVDD employing genome-wide association study data.</p><p><strong>Methods: </strong>For this observational study, summary statistics for plasma proteins were derived from an Icelandic population, paralleled with genome-wide data on IVDD obtained from the FinnGen consortium. Using two-sample Mendelian randomization, we assessed the causal relationship between 4,907 plasma proteins and IVDD. Standard sensitivity analyses encompassing heterogeneity, pleiotropy, and leave-one-out cross-validation tests confirmed the stability and robustness of the findings. Subsequently, through Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, and protein interaction analyses, we delved into the functional interrelation among identified plasma proteins.</p><p><strong>Results: </strong>A causal association with IVDD was identified for 47 plasma proteins; myoneurin, intersectin 1, and eukaryotic translation initiation factor 4 gamma 3 maintained significant correlations post multiple correction tests (P < 1.02 × 10^- 5), influencing IVDD development positively. GO/KEGG pathway analyses confirmed that multiple pathways may be involved in IVDD development.</p><p><strong>Conclusion: </strong>The study underscores the causal correlation between plasma protein levels and IVDD risk. These identified proteins could emerge as unique biomarkers for IVDD, contributing to its predictive measures. The findings further our understanding of IVDD pathomechanisms and prospective therapeutic targets.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Answer to the letter to the editor of Franz Jooji Onishi concerning \"A systematic review of anterior lumbar interbody fusion (ALIF) versus posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), posterolateral lumbar fusion (PLF)\" by Rathbone J, et al. (Eur Spine J [2023]: doi: 10.1007/s00586-023-07567-x).","authors":"Matthew Scott-Young","doi":"10.1007/s00586-024-08500-6","DOIUrl":"https://doi.org/10.1007/s00586-024-08500-6","url":null,"abstract":"","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is MAGEC X better than earlier designs of magnetically controlled growing rod: an explant study.","authors":"Thomas J Joyce, Goksu Kandemir, David Fender, Andrew J Bowey, Paul R P Rushton","doi":"10.1007/s00586-024-08546-6","DOIUrl":"https://doi.org/10.1007/s00586-024-08546-6","url":null,"abstract":"<p><strong>Purpose: </strong>Determine the performance of MAGEC X rods through retrieval analysis and comparison with clinical data.</p><p><strong>Methods: </strong>A multicentre explant database was searched to identify cases using MAGEC X device. Clinical and surgical data was gathered prospectively. Prior to rod disassembly, rods underwent testing with an external remote controller to measure the force output.</p><p><strong>Results: </strong>Eleven cases from 6 centres were identified. Implantation occurred at mean age 6.9 years with mean duration of implantation 42 months. Dual rod constructs were used in all but one case, providing 21 MAGEC X rods for explant analysis. Tissue metallosis was identified at revision surgery in 8/11 cases (73%). Of the 21 rods, 13/21 (62%) produced no force while 8/21 (38%) produced the force stated by the manufacturer. Endcap separation was seen in 5/21 (24%) rods. Where full disassembly was possible, 13/14 (93%) rods had an intact locking pin. Average rod growth was 18 mm (range 2-45 mm), equivalent to 5.1 mm per year. Wear debris was found within 20/21 (95%) MAGEC X rods.</p><p><strong>Conclusion: </strong>Despite the substantial design changes with MAGEC X tissue metallosis was seen in most cases; most explanted MAGEC X rods had lengthened only partially and produced no force output. While the previous issue of locking pin fracture appears to have been mitigated with MAGEC X, there are multiple other and new failure modes, such as endcap separation. Overall MAGEC X appears to give little improvement over earlier iterations of the rod.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Most AOTL type A and type B thoracolumbar primary fracture line follow the mechanism of an imaging-based injury model.","authors":"Guoping Cai, Bingshan Yan","doi":"10.1007/s00586-024-08552-8","DOIUrl":"https://doi.org/10.1007/s00586-024-08552-8","url":null,"abstract":"<p><strong>Background: </strong>Based on the phenomenon that most thoracolumbar primary fracture line passes the center of the pedicle, we proposed an injury mechanism model to evaluate.</p><p><strong>Methods: </strong>Consecutive patients with thoracolumbar fractures treated operatively between October 2019, and December 2020 were analyzed retrospectively. Demographic and spinal radiographical parameters were measured and recorded. Pedicle hyperintensity on T2-weighted sagittal MR images was labeled. We examined the relationship between the course of the line (Radius) connecting the center of the pedicle of the injured vertebra and the IAR and orientation of the thoracolumbar primary fracture line. A partial correlation test was calculated to find correlations between demographic and spinal radiographical parameters. Nonlinear regression analysis was run with the Radius as the dependent variable and the other spinal kyphosis parameters as the independent variables to verify this model.</p><p><strong>Results: </strong>Ninety-seven patients with 104 thoracolumbar fractures were included in this study. Ninety-four (90.4%) thoracolumbar fractures showed a high signal on MRI T2 through the pedicle. Involvement of the center of the pedicle was distributed among most AOTL Type A and Type B thoracolumbar fractures. In total, 92.3% of primary vertebral fracture lines followed the Radius of the model (r2 = 0.940).</p><p><strong>Conclusions: </strong>We provide a simple and quantifiable spinal instantaneous injury mechanism model for thoracolumbar fractures. Specifically, most AOTL type A and B thoracolumbar primary fracture line conforms to this model.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which components of the global alignment proportionality score have the greatest impact on outcomes in adult spinal deformity corrective surgery?","authors":"Oluwatobi O Onafowokan, Oscar Krol, Virginie Lafage, Renaud Lafage, Justin S Smith, Breton Line, Shaleen Vira, Alan H Daniels, Bassel Diebo, Andrew J Schoenfeld, Jeffrey Gum, Khaled Kebaish, Khoi Than, Han Jo Kim, Richard Hostin, Munish Gupta, Robert Eastlack, Douglas Burton, Frank J Schwab, Christopher Shaffrey, Eric O Klineberg, Shay Bess, Peter G Passias","doi":"10.1007/s00586-024-08540-y","DOIUrl":"https://doi.org/10.1007/s00586-024-08540-y","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of the Global Alignment and Proportion (GAP) score components on patient outcomes in Adult Spine Deformity (ASD) surgery.</p><p><strong>Methods: </strong>Patients included underwent assessment via the GAP score and its individual components: pelvic version (GAP PV), lumbar lordosis (GAP LL), lumbar distribution index (GAP LDI) and spinopelvic component (GAP SP). Multivariable analyses assessed the association between alignment in these components and clinical outcomes in ASD patients.</p><p><strong>Results: </strong>762 ASD patients met inclusion criteria. Alignment in GAP SP independently predicted meeting MCID for SR-22S and ODI and was associated with a lower likelihood of developing mechanical complications. Patients aligned in GAP SP were less likely to develop proximal junctional kyphosis (OR 0.42, 0.26-0.73, p = 0.01) and PJF (OR 0.3, 0.13-0.74, p = 0.01). Proportioned alignment in GAP SP with disproportioned alignment in GAP LDI contributed to an increased risk of PJK and PJF (OR 2.67, 95% CI 1.95-6.82, p = 0.045). There was no significant association of GAP SP proportionality and GAP RPV (OR 1.1, 0.86-2.15, p = 0.253) or GAP LL (OR 1.34, 0.78-4.23, p = 0.673) disproportionality with outcomes. Disproportioned alignment in GAP SP but proportioned alignment in both GAP LL and GAP LDI was associated with decreased likelihood of PJK (OR 0.53, 95% CI 0.39-0.94, p = 0.02) and PJF (OR 0.31, 95% CI 0.19-0.67, p = 0.001).</p><p><strong>Conclusion: </strong>The spinopelvic component of the GAP score is the most significant independent predictor of clinical outcomes. Its interaction with the other components of the GAP score also aids assessment of the risk for mechanical complications.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of outcome following an epidural steroid injection for disc-related sciatica: a Delphi consensus study.","authors":"Siobhan Stynes, Nadine Foster, John O' Dowd, Raymond Ostelo, Kika Konstantinou","doi":"10.1007/s00586-024-08342-2","DOIUrl":"10.1007/s00586-024-08342-2","url":null,"abstract":"<p><strong>Purpose: </strong>Trial data shows modest reductions in leg pain, disability and surgery avoidance following epidural steroid injections (ESI) for severe sciatica. Despite their common use, there is no clear evidence about which patients are more likely to benefit from ESI. The aim of this study was to generate consensus on potential predictors of outcome following ESI for disc-related sciatica.</p><p><strong>Methods: </strong>A list of potential predictors of outcome was generated during a consensus meeting of seven experts. The items were subsequently presented in a two round on-line Delphi study to generate consensus among experts on which items are potential predictors of outcome. Consensus was defined as 70% agreement among participants.</p><p><strong>Results: </strong>Sixty-one items were generated during the consensus meeting. Of ninety experts invited to participate in the on-line Delphi study, 44 (48%) and 33 (73%) took part in rounds one and two respectively. Twenty-eight additional items suggested by participants in round one were included in round two. Overall, 14 items reached consensus reflecting domains of health, medication use, pain intensity, psychosocial factors, imaging findings and type of injection.</p><p><strong>Conclusion: </strong>Based on expert consensus, items that can be routinely collected in clinical practice were identified as potential predictors of outcomes following ESI.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4235-4242"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in predicting postoperative heterotopic ossification following anterior cervical disc replacement.","authors":"Rui Zong, Can Guo, Jun-Bo He, Ting-Kui Wu, Hao Liu","doi":"10.1007/s00586-024-08396-2","DOIUrl":"10.1007/s00586-024-08396-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop and validate a machine learning (ML) model to predict high-grade heterotopic ossification (HO) following Anterior cervical disc replacement (ACDR).</p><p><strong>Methods: </strong>Retrospective review of prospectively collected data of patients undergoing ACDR or hybrid surgery (HS) at a quaternary referral medical center was performed. Patients diagnosed as C3-7 single- or multi-level cervical disc degeneration disease with > 2 years of follow-up and complete pre- and postoperative radiological imaging were included. An ML-based algorithm was developed to predict high grade HO based on perioperative demographic, clinical, and radiographic parameters. Furthermore, model performance was evaluated according to discrimination and overall performance.</p><p><strong>Results: </strong>In total, 339 ACDR segments were included (61.65% female, mean age 45.65 ± 8.03 years). Over 45.65 ± 8.03 months of follow-up, 48 (14.16%) segments developed high grade HO. The model demonstrated good discrimination and overall performance according to precision (High grade HO: 0.71 ± 0.01, none-low grade HO: 0.85 ± 0.02), recall (High grade HO: 0.68 ± 0.03, none-low grade HO: 0.87 ± 0.01), F1-score (High grade HO: 0.69 ± 0.02, none-low grade HO: 0.86 ± 0.01), and AUC (0.78 ± 0.08), with lower prosthesis‑endplate depth ratio, higher height change, male, and lower postoperative-shell ROM identified as the most important predictive features.</p><p><strong>Conclusion: </strong>Through an ML approach, the model identified risk factors and predicted development of high grade HO following ACDR with good discrimination and overall performance. By addressing the shortcomings of traditional statistics and adopting a new logical approach, ML techniques can support discovery, clinical decision-making, and intraoperative techniques better.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4082-4091"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A deep neural network for MRI spinal inflammation in axial spondyloarthritis.","authors":"Yingying Lin, Shirley Chiu Wai Chan, Ho Yin Chung, Kam Ho Lee, Peng Cao","doi":"10.1007/s00586-023-08099-0","DOIUrl":"10.1007/s00586-023-08099-0","url":null,"abstract":"<p><strong>Objective: </strong>To develop a deep neural network for the detection of inflammatory spine in short tau inversion recovery (STIR) sequence of magnetic resonance imaging (MRI) on patients with axial spondyloarthritis (axSpA).</p><p><strong>Methods: </strong>A total 330 patients with axSpA were recruited. STIR MRI of the whole spine and clinical data were obtained. Regions of interests (ROIs) were drawn outlining the active inflammatory lesion consisting of bone marrow edema (BME). Spinal inflammation was defined by the presence of an active inflammatory lesion on the STIR sequence. The 'fake-color' images were constructed. Images from 270 and 60 patients were randomly separated into the training/validation and testing sets, respectively. Deep neural network was developed using attention UNet. The neural network performance was compared to the image interpretation by a radiologist blinded to the ground truth.</p><p><strong>Results: </strong>Active inflammatory lesions were identified in 2891 MR images and were absent in 14,590 MR images. The sensitivity and specificity of the derived deep neural network were 0.80 ± 0.03 and 0.88 ± 0.02, respectively. The Dice coefficient of the true positive lesions was 0.55 ± 0.02. The area under the curve of the receiver operating characteristic (AUC-ROC) curve of the deep neural network was 0.87 ± 0.02. The performance of the developed deep neural network was comparable to the interpretation of a radiologist with similar sensitivity and specificity.</p><p><strong>Conclusion: </strong>The developed deep neural network showed similar sensitivity and specificity to a radiologist with four years of experience. The results indicated that the network can provide a reliable and straightforward way of interpreting spinal MRI. The use of this deep neural network has the potential to expand the use of spinal MRI in managing axSpA.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4125-4134"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fusion versus decompression alone for lumbar degenerative spondylolisthesis and spinal stenosis: a target trial emulation with index trial benchmarking.","authors":"Ines Unterfrauner, Javier Muñoz Laguna, Miquel Serra-Burriel, Jakob M Burgstaller, Ilker Uçkay, Mazda Farshad, Cesar A Hincapié","doi":"10.1007/s00586-024-08495-0","DOIUrl":"10.1007/s00586-024-08495-0","url":null,"abstract":"<p><strong>Purpose: </strong>The value of adding fusion to decompression surgery for lumbar degenerative spondylolisthesis and spinal canal stenosis remains debated. Therefore, the comparative effectiveness and selected healthcare resource utilization of patients undergoing decompression with or without fusion surgery at 3 years follow-up was assessed.</p><p><strong>Methods: </strong>Using observational data from the Lumbar Stenosis Outcome Study and a target trial emulation with index trial benchmarking approach, our study assessed the comparative effectiveness of the two main surgical interventions for lumbar degenerative spondylolisthesis-fusion and decompression alone in patients with lumbar degenerative spondylolisthesis and spinal canal stenosis. The primary outcome-measure was change in health-related quality of life (EuroQol Health Related Quality of Life 5-Dimension 3-Level questionnaire [EQ-5D-3L]); secondary outcome measures were change in back/leg pain intensity (Numeric Rating Scale), change in satisfaction (Spinal Stenosis Measure satisfaction subscale), physical therapy and oral analgesic use (healthcare utilization).</p><p><strong>Results: </strong>153 patients underwent decompression alone and 62 had decompression plus fusion. After inverse probability weighting, 137 patients were included in the decompression alone group (mean age, 73.9 [7.5] years; 77 female [56%]) and 36 in the decompression plus fusion group (mean age, 70.1 [6.7] years; 18 female [50%]). Our findings were compatible with no standardized mean differences in EQ-5D-3L summary index change score at 3 years (EQ-5D-3L German: 0.07 [95% confidence interval (CI), - 0.25 to 0.39]; EQ-5D-3L French: 0.18 [95% CI, - 0.14 to 0.50]). No between-group differences in change in back/leg pain intensity or satisfaction were found. Decompression plus fusion was associated with greater physical therapy utilization at 3 years follow-up.</p><p><strong>Conclusion: </strong>Decompression alone should be considered the primary option for patients with lumbar degenerative spondylolisthesis and spinal stenosis.</p>","PeriodicalId":12323,"journal":{"name":"European Spine Journal","volume":" ","pages":"4281-4291"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}